Britam is a leading diversified financial services group, listed on the Nairobi Securities Exchange. The group has interests across the Eastern and Southern Africa region, with operations in Kenya, Uganda, Tanzania, Rwanda, South Sudan, Mozambique and Malawi. The group offers a wide range of financial products and services in Insurance, Asset management, Ban...
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Medical Claims Assistant (Short-Term Contract - 3 Months)
- Job TypeContract
- QualificationBA/BSc/HND
- Experience
- LocationNairobi
- Job FieldInsurance  , Medical / Healthcare 
Job Purpose:
- To support the effective and timely reconciliation, processing, and payment of BMI medical claims, ensuring quality and cost-effective care for clients. The role also includes contributing to the resolution of the current claims backlog within a defined period, while maintaining high standards of accuracy, customer service, and policy compliance.
Key Responsibilities:
Claims Backlog Clearance:
- Support the reconciliation and sign-off of pending claims to meet the three-month backlog clearance target, ensuring accuracy and adherence to policy guidelines.
Claims Review and Processing:
- Evaluate and process inpatient and outpatient claims in line with Britam’s policies, clinical standards, and documentation requirements.
Customer and Provider Engagement:
- Liaise with service providers and clients to ensure medical care is delivered within covered limits, while managing expectations professionally and promptly.
Claims Compliance:
- Review claims and medical reports to ensure compliance with scheme benefits and clinical appropriateness.
Claims Verification and Audit:
- Conduct verification and audits of submitted claims to minimize fraud, errors, and misuse.
Documentation Management:
- Track, follow up, and validate all necessary documentation to complete claims processing within the required turnaround time.
Reporting and Data Management:
- Maintain accurate records of claims transactions, prepare claims registers, and contribute to periodic reporting and performance tracking.
Delegated Authority:
- Act within the scope defined by the approved Delegated Authority Matrix.
Knowledge, Experience, and Qualifications Required:
- Bachelor's degree in Business Administration or related field.
- Excellent attention to detail.
- Good interpersonal and communication skills.
- Ability to work under pressure and meet tight deadlines.
- Proficiency in Microsoft Office and medical claims systems
Method of Application Interested and qualified? Go to Britam on britam.taleo.net to apply
